Evidence map›Paper›PMID 41462416›Full record

ArticleScientific reports2025

Proton pump inhibitors have no effect on short or long term rebleeding or mortality in patients with overt gastrointestinal bleeding.

Jamil Mrad, Ali Elhadi Zreik, Chantal Rizk, Reem Mansour, Hani Tamim, Walaa G El Sheikh, Ala' I Sharara, Fadi H Mourad, Fady Daniel, Assaad Soweid and 4 more

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In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Jamil Mrad *Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Ali Elhadi Zreik *Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Chantal RizkDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Reem MansourDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Hani TamimBiostatistics Unit, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.
Walaa G El SheikhDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Ala' I ShararaDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Fadi H MouradDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Fady DanielDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Assaad SoweidDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Yasser H ShaibDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Noelle El AsmarDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Don C RockeyDigestive Disease Research Center, Medical University of South Carolina, Charleston, SC, USA.
Kassem A BaradaDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. kb02@aub.edu.lb.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Utilization of proton pump inhibitors (PPIs) in patients with overt gastrointestinal bleeding (GIB) is poorly characterized and its impact on clinical outcomes remains unclear. This study determined PPIs utilization in patients with GIB and its impact on short- and long-term mortality and rebleeding. A prospective cohort of patients admitted with GIB from January 2013 to August 2023 at a tertiary referral center was examined. Appropriate use of PPIs was based on AGA guidelines. 846 patients admitted with GIB were followed up until death or August 2023; 462 had upper GIB including 243 from acid-related lesions. Overutilization rate of PPIs was 51% upon admission and 27% upon discharge. The underutilization rate was 25% upon discharge. Compared to PPI non-users, PPI users had less endoscopic stigmata of recent hemorrhage (SRH) and decreased need for endoscopic therapy. However, they had similar 1-month and end of follow-up mortality and rebleeding. Independent predictors of 1-month and end of follow up rebleeding were SRH [OR 2.03 (1.16-3.54), and 1.78 (1.21-2.64)], and severe bleeding. Being admitted on anticoagulants was predictive of 1-month rebleeding [OR 2.3 (1.2, 4.4)], while being discharged on antiplatelets was protective against long term rebleeding [OR 0.45 (0.28-0.72)]. Blood transfusion and Charlson Comorbidity Index were predictors of 1-month and long-term mortality. Being discharged on anticoagulants predicted long-term mortality [OR 2.51(1.45-4.36)]. There is significant over- and underutilization of PPIs in patients with GIB without a significant effect on outcomes. PPI stewardship would likely reduce healthcare costs and minimize side effects.

Indexed as

Gastrointestinal HemorrhageProton Pump InhibitorsAgedAged, 80 and overFemaleHumansMaleMiddle AgedProspective StudiesRecurrenceTreatment OutcomeProton Pump InhibitorsGastrointestinal bleedingMortalityProton pump inhibitorsRebleeding

Identifiers

PMID41462416
PMCPMC12749860

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.